Permit CITY OF TIGARD MECHANICAL PERMIT
s • COMMUNITY DEVELOPMENT Permit #: MEC2012 -00313
T L G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/18/2012
Parcel: 2S102BD00701
Jurisdiction: Tigard
Site address: 12785 SW PACIFIC HWY
Project: Burgerville Subdivision:RTH TIGARDVILLE ADDITION, AMENC Lot: 8
Project Description: Install new walk -in freezer and cooler and (1) rooftop condensing unit, under 200 lbs.
Contractor: PORTLAND MECHANICAL CONTRACTORS Owner: BENNETH, CATHERINE MCNICOL
2000 SE HANNA HARVESTER DR 3830 ROBIN CREEK LN
MILWAUKIE, OR 97222 WEST LINN, OR 97068
PHONE: 503 - 656 -7400 PHONE:
FAX: 503 - 655 -0620
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 06/18/2012 $474.71
Class of Work: ALT Type of Const: VB Plan Review 06/18/2012 $118.68
Occupancy Grp: A -2 Occupancy Load: 12% State Surcharge - Mechanical 06/18/2012 $56.97
Stories: 1 Info Process /Archiving - Sm $0.50 (up to 06/18/2012 $1.00
11x17)
Project Valuation: $15,000.00
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressure: Units > 10000 cfm:
Furnaces Boilers & Compressors
Furnaces < 100K BTU: 0 -3 HP:
Furnaces >= 100K BTU: 3 -15 HP:
Floor Furnaces: 15 -30 HP:
Unit Heaters: 30 -50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $651.36
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: Walk in
Duct Work: cooler
Fire /Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: • AZ .A 1 / / / , /, Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for the next available Inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the Job site at the time of each inspection.
Mechanical Permit Applicat' ( FOR OFFICE USE ONLY
City of Tigard "E�ED Date/By: � Permit No.: / ! , 02-te3",
iii 11 1 13125 SW Hall Blvd., Tigard, OR 97223
C P Revi • i. a 1 0� Other Permit:
Phone: 503.639.4171 Fax: 503.598.190.1N 1 2 2012 Date/By: 41111101, _/
T I G A R D Inspection Line: 503.639 n Date Ready c y: ®r' Ali Juri • • p See Page 2 for
Internet: www.tigard - or.gov CITY Notified/Method: cr ' ' , (� Supplemental Information
BUI Imamw Tl' %
TYPE OF WORK CO MERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction ® Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $ $15,000.00
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building Q
For special information use checklist. v
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total '..
JOB SITE INFORMATION AND LOCATION Heating/cooling Q
Air conditioning Q
Hwy (requires site address: 12785 SW Pacific Hw gquires site plan showing placement) 46.75 Q
City/State /ZIP: Tigard OR 97223 Furnace 100,000 BTU (ducts/vents) 46.75 1
Fumace 100,000+ BTU (duets/vents) 54.91 04
Suite/bldg. /apt. no.: I Project name: Burgerville #45 Tigard Heat pump 61.06
Cross street/directions to job site: Duct work 23.32 Ct
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
c
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: I Lot no.: Flue /vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
Gas fireplace 33.39
Install new walk -in freezer and cooler for restaurant remodel. One rooftop Flue vent for water heater or gas
condensing unit under 200Ibs. fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
❑ PROPERTY OWNER I ® TENANT Chimney /liner /flue /vent 23.32
Other: 23.32
Name: Burgerville #45 Environmental exhaust and ventilation
Address: 12785 SW Pacific Hwy Range hood/other kitchen
y equipment 33.39
City /State /ZIP: Tigard OR 97223 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
CO APPLICANT ® CONTACT PERSON Attic /crawlspace fans 23.32
Other: 23.32
Business name: Portland Mechanical Contractors Fuel r to
P g
Contact name: Dave Brannon $14.15 for first four; $4.03 for each additional
Address: 2000 SE Hanna Harvester Drive Furnace etc.
Gas heat pump
City /State /Z1P: Milwaukie OR 97222 Wall /suspended/unit heater
Phone: (503) 656 -7400 I Fax: : (503) 655 -0620 Water heater
Fireplace
E -mail: davidb @pmc -g.com Range
CONTRACTOR Barbecue
Business name: Same as above
Clothes dryer (gas)
Other:
Address: MECHANICAL PERMIT FEES*
City /State /ZIP: Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($90.00)
Plan review (25% of permit fee)
CCB lie.: 151807 State surcharge (12% of permit fee)
�j TOTAL PERMIT FEE
Authorized Signature: ,� This permit a expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Dave Brannon I Date: / � / /‹._ • Fee methodology set by Tri- County Building Industry Service Board
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